Selective paralysis of the upper extremities after odontoid fracture: Acute central cord syndrome or cruciate paralysis?

J. Inamasu, S. Hori, F. Ohsuga, N. Aikawa

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A patient presented with selective paralysis of the arms after having sustained a fall. X-ray of the cervical spine showed a type II odontoid fracture with posterior atlantoaxial dislocation. The diagnosis in the emergency room was cruciate paralysis, which is frequently associated with fractures of axis and/or atlas. However, magnetic resonance imaging (MRI) of the cervical spine revealed a lesion consistent with the acute central cord syndrome (CCS) at the C2-C6 level. The patient underwent posterior atlantoaxial arthrodesis to correct instability and was discharged, without much neurological improvement. Cruciate paralysis has been reported to be associated with fractures of axis and/or atlas, and acute CCS has rarely been associated with the fractures. However, this case illustrates that the lesion responsible for selective paralysis of the upper extremities is not as specific as it had been thought to be, and that it is difficult to accurately identify the level of the cervical cord injury by neurological diagnosis and X-rays alone. Supplementary diagnostic modalities, particularly MRI, are required to make a correct diagnosis and develop a therapeutic strategy.

Original languageEnglish
Pages (from-to)238-241
Number of pages4
JournalClinical Neurology and Neurosurgery
Volume103
Issue number4
DOIs
Publication statusPublished - 2001

Fingerprint

Central Cord Syndrome
Upper Extremity
Paralysis
Atlases
Spine
Magnetic Resonance Imaging
X-Rays
Arthrodesis
Hospital Emergency Service
Arm
Wounds and Injuries

Keywords

  • Acute central cord syndrome
  • Atlantoaxial dislocation
  • Cruciate paralysis
  • Odontoid fracture

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Selective paralysis of the upper extremities after odontoid fracture : Acute central cord syndrome or cruciate paralysis? / Inamasu, J.; Hori, S.; Ohsuga, F.; Aikawa, N.

In: Clinical Neurology and Neurosurgery, Vol. 103, No. 4, 2001, p. 238-241.

Research output: Contribution to journalArticle

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